SilverScript Plus 2020 Maryland Medicare Part D Plan S5601-011

On this page we help consumers: Compare SilverScript Plus, a 2020 Medicare Prescription Drug Plan (PDP) available in Maryland for $80.30/month with a $0.00 deductible, with all Medicare Part D Plans in MD.

SilverScript Plus is a 4.0 Star Medicare Part D Plan for Medicare Beneficiaries in Maryland

CMS gave this prescription drug plan a quality rating of 4.0 out of 5.0 stars (Above Average).

These are the areas of the plan that are important to compare and review:

• Premium & Deductible: The premium is the amount you will pay monthly. Plud, many plans have an annual deductible that must be met before cost sharing begins.
• Coverage Phases: Part D plans have an initial coverage limit, followed by a coverage gap, and then catastropic coverage. Some plans offer some coverage in the gap.
• Co-pays & Co-insurance: If you have regular prescriptions, it's critical to verify that your drugs are covered and to know what you will pay at the pharmacy.
• CMS Ratings: Important measurements across 4 different areas that will help you understand how well this plan will care for you.

Cost Details

SilverScript Plus is a cost sharing prescription drug plan (PDP). There are three distinct costs: monthly premiums, an annual deductible, and co-payments or co-insurance.

Premium

The annual premium on this PDP is $963.60 ($80.30 per month), and breaks down as follows:

Basic Premium:	$66.80
Supplemental Premium:	$13.50
Full Premium:	$80.30

Low-Income Subsidy

This plan is not available to people receiving full Low Income Subsidy (LIS) benefits.

Deductible

There is a $0.00 annual deductible with this PDP.

A zero dollar ($0.00) deductible means you have first dollar coverage. Many Part D Plans have a deductible (up to $435 per year in 2020) that must be paid before your prescription coverage assistance kicks in.

You Pay the Premium + Deductible + Copayments

Be aware that you must continue to pay your monthly premium even when you are not using any medications. Also, it's important to plan ahead because you are responsible for one hundred percent of your prescription costs until the plan's deductible has been met. You also make the required copayment when you pick up your prescriptions. These are your share of the prescription drug costs. The plan pays the rest until you reach the coverage gap (aka, “donut hole”).

What You Pay Could Be Different

There are two conditions that could affect how much you pay for this plan. If you qualify for the Social Security Extra Help program your premium will generally be lower. Also, if you enrolled late the Centers for Medicare and Medicaid Service may impose a premium penalty. Contact your local Maryland Medicare Insurance Agent to get an exact quote for your situation.

Coverage Details

SilverScript Plus is a Enhanced PDP. At a minimum, SilverScript must offer a "standard benefit" package mandated by law. The standard benefit includes an annual deductible and a gap in coverage, aka, donut hole. Carriers may also offer plans that:

• are actuarially equivalent to the standard benefit; or
• are enhanced, offering benefits in addition to the standard benefit.

Typically, enhanced plans offer additional coverage during the coverage gap. If you fell into the donut hole last year, shop enhanced plans.

Initial Coverage Limit

It's important to understand the initial coverage limit (ICL) and how it applies to you in Maryland. The ICL is where you share the cost of your prescriptions with the insurance company. You and SilverScript each pay your share until you reach a total of $4020.00 (retail spending) spent at the pharmacy on prescriptions. At that point, you pay all costs yourself because you're in the coverage gap, as explained below.

Coverage Gap (aka, Donut Hole)

The coverage gap, or donut hole, as it is often called, is the coverage phase where you no longer receive assistance from the plan. In other words, you pay for your prescriptions out-of-pocket. How quickly you reach the coverage gap with SilverScript Plus all depends on your prescriptions. Most seniors never fall into the donut hole.

In the coverage gap phase you are responsible for the full cost of your prescription drugs up until your total out-of-pocket expenses reach $6,350 (excluding premiums and expense paid by insurance) minus a 75% discount on both brand-name prescription drugs and generics. Once you reach $6,350 in out-of-pocket expenses, you're out of the coverage gap. At this point, you automatically get catastrophic coverage through Medicare, which assures you only pay a small amount for covered drugs for the remainder of the year.

Additional Gap Coverage

SilverScript Plus offers some additional assistance in the coverage gap. See the plan's Summary of Benefits for details. If you reached the coverage gap last year and were not able to afford your medications, be sure to check with your local Maryland Medicaid office. You may qualify for additional assistance. The Social Security Administration's Extra Help program is another opportunity for seniors on Medicare who are not able to afford their prescriptions.

Copayment & Coinsurance Details

In addition to the monthly premium and annual deductible, the SilverScript Plus prescription drug plan has copayments (fixed dollar amount) and/or coinsurances (percentage) that you must pay when you pickup your medications. Here's the schedule for this plan:

Tier	Preferred	Standard
1 (Preferred Generic)	$0.00 copay	$5.00 copay
2 (Generic)	$2.00 copay	$10.00 copay
3 (Preferred Brand)	$47.00 copay	$47.00 copay
4 (Non-Preferred Drug)	50%	50%
5 (Specialty Tier)	33%	33%

IMPORTANT: In order to determine if this is the best PDP for you, it's critical that you look up your prescriptions in the plan's formulary.

Medicare Part D Star Ratings

In this section we show you the quality rating for this plan. Each year the Centers for Medicare and Medicaid Services (CMS) rates prescription drug plans in four broad categories. We do not recommend joining a plan with an overall rating less than 3.0. The following marks will give you an idea of the level of care you will receive if you join this SilverScript plan.

2020 Overall Rating
Drug Plan Customer Service
Complaints and Changes in the Drug Plan
Member Experience with the Drug Plan
Drug Safety and Accuracy of Drug Pricing

Contact SilverScript

Here's the new member contact information for SilverScript:

Prospective Members:	(866)552-6106
TTY Users:	(711)-
Plan Website:	http://www.silverscript.com
Formulay Information:	http://www.SilverScript.com
Pharmacy Information:	http://www.SilverScript.com

For assistance 24 hours a day, call 800-633-4227. TTY users should call 877-486-2048. If you qualify for Medicare but have not yet enrolled or verified your enrollment status, you can do so on the Social Security Administration website. You can learn more about the Medicare Part D program on www.medicare.gov or the Wikipedia page. For information about the SSA's Extra Help program, download the Understanding Extra Help guide.

Compatibility

This stand-alone Medicare Part D plan is compatible with Medicare Part A (hospital insurance) and Medicare Part B (medical insurance), and all Maryland Medigap plans. It's also compatible with Medicare Part C plans in Maryland, so long as the plan does not include prescription drug coverage.

Availability

If you are entitled to Medicare Part A (enrolled or not) or currently enrolled in Medicare Part B you may join the SilverScript Plus prescription drug plan. Unless you also receive benefits from Medicaid, enrollment in a Part D plan is voluntary. This plan is available in Baltimore, Columbia, College Park, Frederick, Rockville, Gaithersburg, Bowie, Hagerstown, Annapolis, Salisbury, Laurel, Bethesda, and all other towns and cities in Maryland.

The Medicare Part D information on this page originates from CMS Landscape Source Files, is maintained by David Bynon, and was last updated on December 18, 2019.